DIZZINESS, VERTIGO, UNSTEADINESS & RISK OF FALLS

Statistics

  • 70% of patients with vertigo and dizziness are seen by primary care physicians, only 50% are diagnosed.
  • Over 90 million Americans age 17 and older, have experienced a dizziness or balance problem.
  • 20 to 40 percent of adults over 65 who live at home fall each year.
  • The fear of and result of falls are a major cause of nursing home admissions.
  • Balance-related falls account for more than one-half of the accidental deaths in the elderly.

Symptoms of Vestibular (Inner Ear) Pathology

  • Dizziness/Vertigo
  • Imbalance/Unsteadiness
  • Visual motor disturbances/Nausea
  • Secondary symptoms of: memory problems, muscular stiffness / imbalance / weakness, fatigue, headaches and anxiety may be experienced.

Who is recommending FALL PREVENTION?

The United States Government OSHA has issued a statement of concern regarding falls in the workplace. They have indicated prevention of falls will become a major issue for them.

The Elderly Fall Prevention Act 2002 notes:

  • Falls are the leading cause of injury deaths among people over 65.
  • 25% of elderly persons who sustain a hip fracture die within one year.
  • Hospital admissions for hip fractures among the elderly have increased from 231,000 admissions in 1988 to 332,000 in 1999. The number of hip fractures is expected to exceed 500,000 by 2040.
  • The cost to the Medicare and Medicaid programs and society as a whole from falls by elderly persons continues to climb much faster than inflation and population growth. Direct costs alone will exceed $32 billion in 2020.

American Academy of Orthopedic Surgeons, American Geriatrics Society & British Geriatrics Society

  • All patients over 55 should be screened EVERY YEAR for balance problems and the risk of falling.

Who Should Be Routinely Screened - Vestibular Testing?

  • Anyone who has fallen or has a history of falling
  • Anyone 55 years of age or older
  • Anyone who complains of dizziness / imbalance / vertigo
  • Anyone expressing a fear of falling
  • Anyone 50 years of age or older who is having difficulty adjusting to wearing new glasses, especially bifocals.
  • Anyone 50 years of age or older who has deteriorating hearing or hearing loss which requires treatment or hearing device.
  • Anyone who score high risk on balance screening or history and physical
  • If the balance disorder is determined NOT to be caused by:
    • cardio-vascular conditions
    • cardio-pulmonary conditions
    • diabetic neuropathy
    • peripheral neuropathy
    • adverse effects of medications
    • skeletal injuries / muscular disorders
    • any other non-vestibular etiology

Balance problems frequently include patient complaints of instability, visual instability, and dizziness, Balance affects patients in a variety of populations, including:

  • Amputee Rehabilitation
  • Aviation Medicine
  • Cerebral Vascular Accident (VA)
  • Chemical Toxicity
  • Chronic Mobility Disorders
  • Dizziness/Disequilibrium
  • Fall Risk Identification & Management
  • Head Injury/Concussion
  • Movement Disorders
  • Neuro Degenerative Diseases
  • Orthopedic Injuries
  • Pediatric/Neuro Development
  • Pharmacological/ Ototoxicity
  • Spinal Cord Injury
  • Sports Medicine
  • Vestibular Disorders
  • Worker's Compensation/Medical Legal

VNG

VNG - VideoNystagmoGraphy

What is the MEDTRAK SYSTEM? Diagnostic Component - VNG

Diagnostic component - InfraRed/Video ENG System provides complete two channel Videonystagmography. The patient looks into the goggle or Ocular Motor Module and all the tests can be performed instantly! 

How is the VNG Test Performed?

The test takes less than 45 minutes. No needles or pain.

Using a light weight goggle outfitted with an Infra Red / Video camera, the horizontal and vertical movements of the eye are displayed, saved and analyzed by the software.

VNG Balance

FallTrak System

  • Therapeutic Component- FallTraK is a state -of-the-art, computer-assisted Visual Vestibular Proprioceptive (VVP) Balance Assessment and Training Device that allows for both static and dynamic balance assessment. Therapists are able to use the built-in training modes with ease and flexibility. In addition, the system allows the design of unique, individual training protocols when specific deficits are identified during the test phase.

HOW IS THE FALLTRAK USED

  • Software requires the patient to stand on an platform and perform a series of exercises while looking at a computer monitor. The result is the patient performs exercises that require the Visual, Vestibular and Proprioceptive systems to work together in an integrated manner to accomplish a task. The software provides for the storage and analysis of patients progress.

OUTCOMES OF THERAPY

  • Benign Positional Vertigo 95% (N=5000 patients)
  • Vestibular Neuronitis 75% (N=500 patients)
  • Disequilibrium of Aging 85% (N=200, includes fall reduction)
  • Labyrinthine Concussion 90% (dizziness) 75% (imbalance) (N=100 patients)
  • Acoustic Neuroma 90% (N=100 patients)
  • Ototoxicity 60% (N=15 patients)

What is Computerized Balance Testing?

  • Studies are used to evaluate postural stability both in static and sensory conflict situations.
  • Vision, vestibular function and somato-sensation are tested.
  • This is not a diagnostic site of lesion test, but rather provides information about the patient’s functional abilities.
  • Some responses are related to vestibular dysfunction, but further testing is necessary for a diagnosis.
  • This information is helpful in formulating a specific therapy plan for balance disordered patients.

What is Balance Retraining?
Balance retraining involves exercises designed to improve coordination of muscle responses as well as the organization of sensory information for balance control.

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